Exercise and physical therapy help restore body and self in clients with severe anorexia nervosa

Kolnes, Liv-Jorunn

doi:10.1016/j.jbmt.2016.09.005

Cited by 17 publications

(23 citation statements)

References 91 publications

(94 reference statements)

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“… 52 With regard to nausea/vomiting and loss of appetite, it could not be concluded whether exercise suppressed or promoted these symptoms. Exercise has been reported to promote nausea/vomiting 53 and could promote loss of appetite 54 in healthy people. In contrast, exercise could also suppress these symptoms in noncancer patients.…”

Section: Discussionmentioning

confidence: 99%

Effects of Aerobic and Resistance Exercises on Physical Symptoms in Cancer Patients: A Meta-analysis

et al. 2018

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Objective. This study aimed to conduct a meta-analysis to establish the effect of exercise interventions on physical symptoms, including fatigue, nausea/vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, and diarrhea in cancer patients and survivors. Methods. We searched articles published before April 2017 using the following databases: Cochrane Library, PubMed/MEDLINE, CINAHL, Scopus, PEDro, Health & Medical Collection, and Psychology Database. Randomized controlled trials (RCTs) of exercise intervention in cancer patients, which evaluated cancer-related physical symptoms using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, were included. Symptom scale data were extracted for meta-analysis. Subgroup analyses were performed for exercise types (aerobic, resistance, and mixed exercise programs). Results. Of the 659 articles, 10 RCTs were included in the meta-analysis, of which the mean PEDro score was 5.43 (SD = 1.28). Fatigue, pain, dyspnea, and insomnia were significantly lower in the intervention group than in the control group at postintervention in cancer patients. However, exercise intervention did not promote or suppress nausea/vomiting, loss of appetite, constipation, and diarrhea in cancer patients. The effect of exercise type on each symptom was not different. Conclusion. Exercise intervention was confirmed to improve fatigue, pain, and insomnia and might have reduced dyspnea in cancer patients. However, the benefits of exercise on nausea/vomiting, loss of appetite, constipation, and diarrhea were not shown in any exercise type. Further research is warranted to examine the effects of exercise interventions on physical symptoms in cancer patients.

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Section: Discussionmentioning

confidence: 99%

Effects of Aerobic and Resistance Exercises on Physical Symptoms in Cancer Patients: A Meta-analysis

et al. 2018

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“…NPMP is described in more detail elsewhere 32. The method differs from traditional physiotherapy in that it understands the body to be a functionally integrated entity, such that (1) constriction in one part of the body influences the steadiness of the entire body and (2) that lived experiences and feelings are embedded within the body 32 40. The assessment of the breathing pattern is of particular interest, as it is assumed that emotional or physical stress over time may constrict the breathing and cause tension in bodily function and movements 30.…”

Section: Methodsmentioning

confidence: 99%

Physiotherapy improves symptoms of exercise-induced laryngeal obstruction in young elite athletes: a case series

Kolnes

Vollsæter

Røksund

et al. 2019

BMJ Open Sport Exerc Med

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ObjectiveA constricted, upper chest breathing pattern and postural dealignments habitually accompany exercise-induced laryngeal obstruction (EILO), but there are few effective treatments for athletes presenting with EILO. This case series was conducted to examine whether physiotherapy based on principles from the Norwegian psychomotor physiotherapy (NPMP) combined with elements of cognitive behavioural therapy can reduce laryngeal distress in athletes with EILO.MethodsRespiratory distress in four subjects was examined by interview prior to a physiotherapeutic body examination. Inappropriate laryngeal movements during exercise were measured by the continuous laryngoscopy exercise test, lung function was measured by flow-volume curves, and non-specific bronchial hyper-responsiveness was measured by a methacholine provocation test. History of asthma, allergy and respiratory symptoms was recorded in a modified AQUA2008 questionnaire. Parasympathetic activity was assessed by pupillometry. All data were gathered before and after 5 months of intervention.ResultsPhysiotherapy based on the principles from NPMP improved breathing problems in athletes with EILO. All athletes had less respiratory distress, improved lung function at rest and reduced inappropriate laryngeal movements during maximal exercise.ConclusionA diaphragmatic breathing pattern, a more balanced tension in respiratory muscles, and sound cervical alignment and stability may help to reduce adverse stress on the respiratory system and optimise the function of the larynx during high-intensity exercise. Our results suggest that understanding and management of EILO need to extend beyond structures located in the anterior neck and include factors influencing the whole respiratory system.

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“…A pattern of upper chest breathing accompanied by increased muscle tension in respiratory muscles, possibly triggered by increased parasympathetic activity as previously shown in endurance athletes (Filipe, Falcao-Reis, Castro-Correia, & Barros, 2003;Kaltsatou, Kouidi, Fotiou, & Deligiannis, 2011), is frequently seen in young elite athletes with EILO receiving physical therapy for their breathing difficulties (Kolnes, 2016b). If upper chest breathing becomes the habitual breathing pattern, compensatory changes such as increased activation of respiratory muscles, absence of diaphragmatic descent and postural de-alignments characterized by a forward head posture and increased extension of the lower cervical spine are likely to emerge (Kapreli, Vourazanis, & Strimpakos, 2008;Kolnes, 2016a;Perri & Halford, 2004). Eventually, proprioception and neuromuscular control of the muscles of the neck become disrupted and the neuromuscular coordination of cervical movements during respiration is impaired, subsequently affecting the position of the larynx and laryngeal movements.…”

Section: Discussionmentioning

confidence: 99%

“…Such a standing position requires modest muscular effort and allows for spontaneous changes in posture and breathing pattern. Clinical experiences have demonstrated that the breathing typically become less restrained and more diaphragmatic as the person´s posture alters from being rigid and inflexible to becoming more balanced and flexible (Kolnes, 2016a).…”

Section: Discussionmentioning

confidence: 99%

Exercise-induced laryngeal obstruction in athletes: Contributory factors and treatment implications

Kolnes

Stensrud

2018

Physiotherapy Theory and Practice

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Otherwise healthy adolescent athletes presenting with respiratory symptoms consistent with exercise-induced laryngeal obstruction (EILO) are frequently encountered in clinical practice. The symptoms are often incorrectly considered to result from exercise-induced asthma, and may be wrongly treated as such. Given the potential implications for health and performance if EILO is left untreated, a more comprehensive understanding of contributory mechanisms is essential in order to create appropriate treatment procedures. Informed by knowledge from physical therapy, as well as the fields of voice rehabilitation and vocal pedagogy, this theoretical article presents a novel way of understanding and managing EILO by exploring bodily mechanisms and structures that may disturb laryngeal function during strenuous exercise. Firstly, the status quo of the EILO diagnosis, its aetiology and treatment options are reviewed. Secondly, considerations associated with laryngeal structures and mechanisms, and their potential influence on laryngeal movement and sensitivity are examined. Thirdly, the manner in which postural de-alignment and breathing pattern may interfere with laryngeal functioning will be discussed. Finally, interventions for voice disorders and singing and the relevance of these for EILO are evaluated. It is argued that clients with EILO should undergo a thorough physical examination to identify constrictions in the body as a whole - such as postural de-alignments and a dysfunctional breathing pattern - as these are hypothesized as playing a critical role in laryngeal tightness during exercise. Physical therapists possess particular skills and competence with regard to examining breathing patterns and postural de-alignments, and should be included in the treatment process of EILO.

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Exercise and physical therapy help restore body and self in clients with severe anorexia nervosa

Abstract: This file was downloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Kolnes, L.-J. (2017

Cited by 17 publications

References 91 publications

Effects of Aerobic and Resistance Exercises on Physical Symptoms in Cancer Patients: A Meta-analysis

Effects of Aerobic and Resistance Exercises on Physical Symptoms in Cancer Patients: A Meta-analysis

Physiotherapy improves symptoms of exercise-induced laryngeal obstruction in young elite athletes: a case series

Exercise-induced laryngeal obstruction in athletes: Contributory factors and treatment implications

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